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This is a personal view from London as the Covid-19 pandemic continues to spread here and the situation changes from day to day. As such it can only be a snapshot caught in time; it is not a diary of events. The Coronavirus Act 2020 gives Government enormous powers and was passed by Parliament in one day of debate immediately before it closed early for the Easter break. In March, the government imposed a “lockdown: the closure of all” but “essential” businesses and people other than essential workers must work from home but are allowed out for exercise and food shopping but must maintain 2 m apart, the “social distancing rule”. The aim is to suppress the spread of the virus, reduce the death toll and “protect the National Health Service (NHS)” which needed time to empty wards and expand its intensive care unit (ICU) capability to deal with an expected influx of thousands of very sick patients. I discuss whether this strategy is working, how and why it has rapidly been altered to respond to criticism. Why was the Government so slow to seek the help of private laboratories to assist with testing? Why was the personal protective equipment (PPE) guidance altered only after criticism? I look at the impact of the lockdown on the UK economy, the changes to practice of medicine and speeding of scientific research. Cooperating with the lockdown has its price; is it harming the health and mental health of children, people living in households with potentially abusive partners or parents and those who are disabled or financially desperate? Is the cure worse than the disease? The Economy is being devastated by the lockdown and each day of lockdown it is worse. Is litigation being seeded even now by the pandemic? Notwithstanding unprecedented Government financial help many businesses are on the edge of collapse, people will lose their jobs and pensioners income. The winners include pharmacies, supermarkets, online food retailers, Amazon, online apps, providers of video games, services, streaming and scientific research laboratories, manufacturers of testing kits, ventilators, hand sanitisers, coffins, undertakers, etc. The British public is cooperating with lockdown but are we less productive at home? Parents with babies and children often child minders, school, grandparents or paid help which is not now available. Will current reliance on video-conferencing and video calls permanently change the way we work and will we need smaller city offices? Will we travel less? Will medical and legal practice and civil and criminal trials be generally carried out remotely? Will social distancing with self-isolation and job losses and business failures fuel depression? Is Covid-19 comparable to past epidemics like the Plague and Spanish flu?

We conducted a pilot assessment of the feasibility of implementing the International Alcohol Control (IAC) Study in Ontario, Canada, to allow for future comparisons on the impacts of alcohol control policies with a number of countries.The IAC Study questionnaire was adapted for use in the province of Ontario, and a split-sample approach was used to collect data. Data were collected by computer-assisted telephone interviewing of 500 participants, with half the sample each answering a subset of the adapted IAC Study survey.Just over half of the sample (53.6%) reported high frequency drinking (once a week or more frequently), while 6.5% reported heavy typical occasion drinking (8 drinks or more per session). Self-reported rates of alcohol-related harms from one's own and others' drinking were relatively low. Attitudes towards alcohol control varied. A substantial majority supported more police spot checks to detect drinking and driving, while restrictions on the number of alcohol outlets and increases in the price of alcohol were generally opposed.This pilot study demonstrated that the IAC Study survey can be implemented in Canada with some modifications. Future research should assess how to improve participation rates and the feasibility of implementing the longitudinal aspect of the IAC Study. This survey provides additional insight into alcohol-related behaviours and attitudes towards alcohol control policies, which can be used to develop appropriate public health responses in the Canadian context.Nous avons mené une évaluation pilote sur la faisabilité de la mise en œuvre de l’étude internationale sur le contrôle de l’alcool (IAC, pour International Alcohol Control) en Ontario (Canada) afin de pouvoir comparer les répercussions des politiques sur le contrôle de l’alcool dans différents pays.Le questionnaire de l’étude IAC a été adapté pour la province de l’Ontario. Les données ont été recueillies selon une approche par échantillon fractionné, au moyend’entrevues téléphoniques assistées par ordinateur réalisées auprès de 500 participants, chaque moitié de l’échantillon répondant à un sous­ensemble de l’enquête adaptée de l’étude IAC.Un peu plus de la moitié de l’échantillon (53,6 %) a fait état d’une consommation fréquente d’alcool (une fois par semaine ou plus fréquemment) et 6,5 % des répondants ont fait état d’une consommation excessive occasionelle d’alcool élevée (8 consommations ou plus par occasion). Les taux de méfaits liés à l’alcool dont ont fait état les répondants, qu’il s’agisse de leur propre consommation ou de celle des autres, sont demeurés relativement faibles. Les attitudes à l’égard du contrôle de l’alcool étaient variées. La grande majorité des répondants s’est prononcée en faveur d’une augmentation du nombre de contrôles policiers d’alcoolémie pour détecter les cas de conduite avec facultés affaiblies, alors que les restrictions sur le nombre de points de vente d’alcool et l’augmentation du prix de l’alcool ont été généralement rejetées.Cette étude pilote a démontré que l’enquête IAC peut être mise en œuvre au Canada après quelques modifications. Les futurs travaux de recherche auront à explorer des moyens d’améliorer les taux de participation et la faisabilité de la mise en œuvre de l’aspect longitudinal de l’étude IAC. Cette enquête fournit des renseignements supplémentaires sur les comportements liés à l’alcool et sur les attitudes à l’égard des politiques de contrôle de l’alcool utilisables pour élaborer des interventions de santé publique propres au contexte canadien.The estimates of average drinks per months from the International Alcohol Control (IAC) Study were significantly higher than those from the Centre for Addiction and Mental Health (CAMH) Monitor (26.3 vs 19.4). The typical drinking session at a public special event or while camping or staying at a cabin/cottage approximated a binge-drinking session (5+ for men, 4+ for women). Only 8.3% of respondents were in favour of a policy of increasing the price of alcohol. Those who had purchased alcohol in the past six months from a grocery store showed significantly higher rates of over-drinking (53.5% vs. 40.54%) as compared to those who had not.Les estimations du nombre moyen de consommations par mois d’après l’étude internationale sur le contrôle de l’alcool (IAC, pour International Alcohol Control) étaient sensiblement plus élevées que celles de l’enquête Monitor du Centre de toxicomanie et de santé mentale (CAMH) de Toronto (26,3 contre 19,4). La consommation d’alcool typique lors d’un événement public spécial ou lors d’un séjour en camping ou dans un chalet se rapprochait d’une consommation excessive occasionnelle (5 consommations ou plus pour les hommes, 4 consommations ou plus pour les femmes). Seuls 8,3 % des répondants se sont montrés favorables à une politique d’augmentation du prix de l’alcool. Les personnes qui ont acheté de l’alcool dans une épicerie au cours des six derniers mois ont affiché des taux de surconsommation nettement plus élevés (53,5 % contre 40,54 %) que ceux qui n’en ont pas acheté.

To determine the effects of the COVID-19 associated restrictions on the ability of owners in Michigan (MI), USA versus Ontario (ON) and British Columbia (BC), Canada, to obtain care for their chronically painful dogs.Cross-sectional survey.A total of 90 owners met the inclusion criteria for the study.An anonymous electronic survey was distributed to owners at four veterinary integrative medicine (IM) clinics during July and August 2020. Two clinics in MI and one each in ON and BC were recruited. Owners were asked about availability of IM care preceding and during COVID-19 restrictions and their opinions of the impact of COVID-19 on their dog's health. The survey asked where owners sought care for their dogs, types of chronic conditions treated, therapeutic modalities used, and if owners had a medical background. Comparisons were made within and between groups. Thematic analysis, Fisher's exact test, chi-square analyses, McNemar's and Wilcoxon signed-rank tests for paired comparisons were performed (p0.05).During COVID-19 restrictions, access to IM care was better for dogs in ON and BC than in MI (p0.001). The negative effect of the pandemic restrictions to IM care on quality of life was perceived greater by owners in MI than those in ON and BC (p0.001). The owners' medical backgrounds had no effect on attempts to access care during this time (p = 0.76).The results suggest that a widespread disease in humans had an adverse impact on animal welfare. Providers of veterinary care should use this experience to establish protocols to ensure continuity of care for chronically painful animals in the event of a similar situation in the future.

Objective. The global Covid-19 pandemic constitutes an unprecedented global challenge. Assuming the crucial role of information systems in orienting societies in times of crisis, it is necessary to investigate the role the media played reporting on the Covid-19 crisis and the related social control policies. Focusing on the Italian press, the study aims to analyse the journalistic coverage of the first phase of the Covid-19 pandemic, trying to understand if it supported the government’s social control policies or questioned them. Design. A computerised content analysis was done on 23,720 articles published by six Italian newspapers in the very first weeks of the health emergency in 2020 and a qualitative analysis of a selection of those articles. Quantitative analysis helped to pinpoint the main topics covered, while the qualitative analysis revealed three main narrative expedients adopted by newspapers to report the emergency. Conclusion. Despite the structural characteristics of the Italian media system, the press was able to perform a service role, fostering the new social control policies and avoiding a polarisation of the debate.

RESUMO A participação da comunidade constitui um princípio constitucional orientador do sistema público de saúde no Brasil, regulamentado pela Lei nº 8.142 de 1990. Objetivou-se compreender os desafios enfrentados para a efetiva participação popular e o controle social na gestão do Sistema Único de Saúde (SUS). Para isso, foi realizada revisão integrativa da literatura nas bases de dados do PubMed, Lilacs, Scopus, Embase e Web of Science, a partir de descritores indexados e seus sinônimos, nos idiomas português, inglês e espanhol. Como critérios de inclusão, foram considerados artigos completos publicados entre os anos de 1988 e 2020, nos idiomas supracitados. E, para exclusão, teses, dissertações, monografias, manuais e artigos duplicados. Foram selecionados 64 artigos que abordavam como desafios a luta por interesses próprios, a influência político-partidária, o distanciamento entre representantes e representados, a falta ou inadequada capacitação permanente em saúde, a deficiência de infraestrutura dos espaços deliberativos, entre outros. Nesse sentido, para a superação dos obstáculos, é fundamental que seja garantida a pluralidade de membros, critérios transparentes na sua escolha, rotatividade de conselheiros, desenvolvimento de gestão transparente, democratização da informação e capacitação dos conselheiros de saúde, por meio de práticas de educação permanente. ABSTRACT Community participation is a constitutional guiding principle of the public health system in Brazil, regulated by Law No. 8.142, of 1990. The objective was to understand the challenges faced for effective popular participation and social control in the management of the Unified Health System (SUS). For this purpose, an integrative literature review was carried out in the databases of PubMed, Lilacs, Scopus, Embase and Web of Science, using indexed descriptors and their synonyms, in Portuguese, English and Spanish. As inclusion criteria, complete articles published between 1988 and 2020 were considered, in the aforementioned languages. And, as exclusion, theses, dissertations, monographs, manuals and duplicate articles. The 64 articles selected addressed as challenges the struggle for their own interests, the political-party influence, the distance between representatives and those represented, the lack or inadequate permanent health training, the lack of infrastructure in deliberative spaces, among others. In this sense, in order to overcome obstacles, it is essential to guarantee the plurality of members, transparent criteria in their choice, turnover of counselors, development of transparent management, democratization of information and training of health counselors, through educational practices permanent.

Guided by the Theory of Planned Behaviour, this study investigates littering attitudes, social norms, and perceived behavioural control as predictors of the intention to prevent littering and actual littering prevention behaviour among residents of a developing country (Nigeria). The study employed a survey questionnaire to collect cross-sectional data. By applying structural equation modelling it was found that people who intend to prevent littering are also more likely to engage in actual littering prevention behaviour. At the same time, the perceived behavioural control had a significant influence on littering prevention intention. The study's findings can assist waste managers in formulating policies and interventions targeting behavioural intention and perceived behavioural control to foster littering prevention. Further, environmental managers should engage applied social and environmental psychologists or social scientists to design such behaviour change programmes.

In an effort to contain the spread of COVID-19, many states and countries have adopted public health restrictions on activities previously considered commonplace: crossing state borders, eating indoors, gathering together, and even leaving one’s home. These policies often focus on specific activities or groups, rather than imposing the same limits across the board. In this Article, I consider the law and ethics of these policies, which I call tailored policies.In Part II, I identify two types of tailored policies: activity-based and group-based. Activity-based restrictions respond to differences in the risks and benefits of specific activities, such as walking outdoors and dining indoors. Group-based restrictions consider differences between groups with respect to risk and benefit. Examples are policies that treat children or senior citizens differently, policies that require travelers to quarantine when traveling to a new destination, and policies that treat individuals differently based on whether they have COVID-19 symptoms, have tested positive for COVID-19, have previous COVID-19 infection, or have been vaccinated against COVID-19. In Part III, I consider the public health law grounding of tailored policies in the principles of “least restrictive means” and “well-targeting.” I also examine how courts have analyzed tailored policies that have been challenged on fundamental rights or equal protection grounds. I argue that fundamental rights analyses typically favor tailored policies and that equal protection does not preclude the use of tailored policies even when imperfectly crafted. In Part IV, I consider three critiques of tailored policies, centering on the claims that they produce inequity, cause harm, or unacceptably limit liberty. I argue that we must evaluate restrictions comparatively: the question is not whether tailored policies are perfectly equitable, wholly prevent harm, or completely protect liberty, but whether they are better than untailored ones at realizing these goals in a pandemic. I also argue that evaluation must consider indirect harms and benefits as well as direct and apparent ones.

Submitted by Clarice Rosa Machado (clarice.machado@ufn.edu.br) on 2022-04-06T14:59:24Z No. of bitstreams: 2 Dissertacao_DanieleCristianeSilvaRodriguesFavarini_SemAssinatura.pdf: 845575 bytes, checksum: ef5558f0734df982ae6517f704d3f4b7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Made available in DSpace on 2022-04-06T14:59:24Z (GMT). No. of bitstreams: 2 Dissertacao_DanieleCristianeSilvaRodriguesFavarini_SemAssinatura.pdf: 845575 bytes, checksum: ef5558f0734df982ae6517f704d3f4b7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2021-07-30 The Municipal Health Councils are collegiate instances of social participation organized in the co-management of the Unified Health System - SUS. They are formed by representations of users, health professionals, health service providers and government representatives, who act as advisers. The counselor's role involves some factors that directly affect the process of consolidation and strengthening of these democratic spaces. Considering the above, this study has the following research question: how is the performance in the Municipal Health Council, considering the exercise of citizenship and social control, according to the vision of the councilors? Therefore, the objective of the study is to know the dynamics of action of counselors in the Municipal Health Council of Santa Maria - RS, with a view to exercising citizenship and the visibility of this instance of social control in the community. This is an exploratory-descriptive research with a qualitative approach. The study was carried out at the Municipal Health Council of Santa Maria, Rio Grande do Sul. The study included 14 councilors, 7 of which represented the segment of users and the other 7 the other representations. The study was carried out from August 2020 to June 2021. The technique for data collection was the semi-structured interview, which was carried out via digital platforms, due to the Covid-19 pandemic. Data were analyzed according to thematic content analysis, which was operationally organized into three stages: pre-analysis; exploration of the material; treatment of the results obtained and interpretation. Codes were used to refer to the study participants, defining the letter 'C', initial for counselor, followed by a corresponding number that ranged from 1 to 14. For this study, the ethical aspects were observed, as per Resolution no. 466/2012, of the National Research Council. The project was approved by the Research Ethics Committee, being registered according to approval no. 4,594,892. The data analysis process showed that the Board's dynamics of action corresponds to a set of responsibilities, challenges and possibilities for effective social control. Responsibilities are predominantly linked to the exercise of citizenship, the monitoring of actions and resources used in health, the role of interlocutor between the demands of the community and the defense of the SUS. The challenges remain: effective communication with the community, the low visibility of the Councils with the population and the threats to the health system, accentuated by the economic crisis and the Covid-19 pandemic. As possibilities, the strengthening of local councils, the expansion of communication channels with society and continuing education in health emerged as a way to qualify social control. The dynamics of action of counselors is a complex activity that contributes to citizenship and social control in health. This action is directly influenced by social demands and by the Brazilian socio-economic scenario and, in this sense, it needs a purposeful, not essentially supervisory, posture in the field of health policies. Despite recognized advances, this dynamic needs to achieve greater clarity of their roles in society and education processes may be able to qualify this performance. Os Conselhos Municipais de Saúde são instâncias colegiadas de participação social organizada na cogestão do Sistema Único de Saúde - SUS. São formados por representações de usuários, profissionais da saúde, prestadores de serviços de saúde e representantes do governo, os quais atuam como conselheiros. Na atuação do conselheiro estão envolvidos alguns fatores que incidem diretamente no processo de consolidação e fortalecimento desses espaços democráticos. Considerando o exposto, esse estudo tem a seguinte questão de pesquisa: como ocorre a atuação no Conselho Municipal de Saúde, considerando a exercício da cidadania e do controle social, segundo a visão dos conselheiros? Para tanto, o objetivo do estudo é conhecer a dinâmica de atuação dos conselheiros no Conselho Municipal de Saúde de Santa Maria - RS, com vistas ao exercício da cidadania e à visibilidade dessa instância de controle social na comunidade. Trata-se de uma pesquisa exploratória-descritiva, de abordagem qualitativa. O estudo foi desenvolvido no Conselho Municipal de Saúde de Santa Maria, Rio Grande do Sul. Foram participantes do estudo 14 conselheiros, sendo que sete desses representaram o segmento dos usuários e os outros sete, as demais representações. O estudo foi desenvolvido no período de agosto de 2020 a junho de 2021. A técnica para coleta de dados foi a entrevista semiestruturada, a qual foi realizada via plataformas digitais, em função da pandemia por Covid-19. Os dados foram analisados segundo a análise de conteúdo temática, que operacionalmente foi organizada em três etapas: pré-análise; exploração do material; tratamento dos resultados obtidos e interpretação. Foram utilizados códigos para se referir aos participantes do estudo, ficando definida a letra ‘C’, inicial de conselheiro, seguida de numeração correspondente que variou de 1 a 14. Para a realização deste estudo foram observados os aspectos éticos, conforme Resolução n.º 466/2012, do Conselho Nacional de Pesquisa. O projeto foi aprovado no Comitê de Ética em Pesquisa, estando registrado segundo parecer de aprovação nº 4.594.892. O processo de análise de dados evidenciou que a dinâmica de atuação do Conselho corresponde a um conjunto de responsabilidades, desafios e possibilidades para o efetivo controle social. As reponsabilidades estão vinculadas, de modo predominante, ao exercício da cidadania, ao acompanhamento de ações e de recursos empregados na saúde, ao papel interlocutor entre as demandas da comunidade e à defesa do SUS. Persistem como desafios a comunicação efetiva com a comunidade, a pouca visibilidade dos Conselhos junto à população e as ameaças ao sistema de saúde, acentuadas pela crise econômica e pela pandemia por Covid-19. Como possibilidades, emergiram o fortalecimento dos conselhos locais, a ampliação de canais de comunicação com a sociedade e a educação permanente em saúde como forma qualificar o controle social. A dinâmica de atuação dos conselheiros configura-se como atividade complexa que contribui para a cidadania e o controle social na saúde. Essa atuação é influenciada diretamente pelas demandas sociais e pelo cenário sócio econômico brasileiro e, nesse sentido, necessita de uma postura propositiva, não essencialmente fiscalizatória, no campo das políticas de saúde. Embora os reconhecidos avanços, essa dinâmica precisa alcançar uma maior clareza de seus papeis perante à sociedade e os processos de educação podem ser capazes de qualificar essa atuação.

Sex and sexuality are contentious concepts, blending the deeply personal with the profoundly political. Sex, a biological classification of human and other mammalian and non-mammalian bodies, has extensive sociopolitical and cultural baggage beyond its putative function of referring to (and drawing divisions on the basis of) clusters of reproduction-related bodily features. Sexuality, by which we mean the whole landscape of one’s sexual desires and activities, has also been decoupled from reproduction in various ways over the last half century or more. In this editorial we highlight some of the peripheries of sex as a category, including the embodiment of persons with a diversity of sexrelated physical characteristics, as well as those who may seek to change such characteristics (for example, as a component of gender identity-affirming care). We then articulate a view of sexuality that integrates biological and psychosocial aspects, noting the complex interplay of these factors in human sexual experience. Finally, we suggest that law has a role to play in sex and sexuality and that it should aim to steer a path between (1) untethered individualism in how these concepts and categories are manifested in the public sphere, and (2) dogmatic conservatism, masquerading as realism, that artificially and oppressively constrains such manifestations. We focus on the UK context to frame our discussion.

“Vaccine Passport” Certification Rejecting both a sweeping public Covid-vaccination-passport scheme and a ban on private certification is an easy call. In navigating the large, complex space in bet...

The Chinese government has launched a digital health code system to detect people potentially exposed to the coronavirus 2019 (COVID-19) disease and to curb its spread. Citizens are required to show the health code on their smartphones when using public transport. However, many seniors are not allowed to use public transport due to their difficulties in obtaining health codes, leading to widespread debates about these unfair events. Traditionally, public perceptions and attitudes toward such unfair events are investigated using analytical methods based on interviews or questionnaires. This study crawled seven-month messages from Sina Weibo, the Chinese version of Twitter, and developed a hybrid approach integrating term-frequency–inverse-document-frequency, latent Dirichlet allocation, and sentiment classification. Results indicate that a rumor about the unfair treatment of elderly travelers triggered public concerns. Primary subjects of concern were the status quo of elderly travelers, the provision of transport services, and unfair event descriptions. Following the government’s responses, people still had negative attitudes toward transport services, while they became more positive about the status quo of elderly travelers. These findings will guide government authorities to explore new forms of automated social control and to improve transport policies in terms of equity and fairness in future pandemics.

Background We aimed to study the effect of social containment mandates on ACS presentation during COVID-19 pandemic using location activity and mobility data from mobile phone map services. Methods We conducted a cross-sectional study using data from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) including all ACS presentations during the pandemic until 7 May 2020. Using a count regression model, we adjusted for day of the week, daily weather and incidence of COVID-19. Results A 10% increase in activity around areas of residence was associated with 38% lower rates of ACS hospitalizations, whereas increased activity relating to retail and recreation, grocery stores and pharmacies, workplaces and mode of mobility was associated with 10-20% higher rates of ACS hospitalizations. Conclusion Government policy regarding social containment mandates has important public health implications for medical emergencies such as ACS and may explain the decline in ACS presentations observed during COVID-19 pandemic. Funding Agencies|Knut and Alice Wallenberg FoundationKnut & Alice Wallenberg Foundation Funding Source: Medline; Swedish Heart and Lung FoundationSwedish Heart-Lung Foundation Funding Source: Medline; Swedish Scientific Research CouncilSwedish Research Council Funding Source: Medline; ALF Funding Source: Medline; SSF (TOTAL-AMI) Funding Source: Medline; Bundy Academy Funding Source: Medline; Skane University Hospital Funds Funding Source: Medline; Marta Funding Source: Medline

Key Points Question Is a highly restrictive state policy climate associated with a lower abortion rate? Findings This cohort study of 1178 counties in 18 states evaluated the association between a highly restrictive state legislative climate and the abortion rate in 18 states between 2000 and 2014. A highly restrictive policy climate, when compared with a less restrictive one, was associated with a significantly lower abortion rate by 0.48 abortions per 1000 women, representing a 17% decrease from the median abortion rate of 2.89 per 1000 women. Meaning This study provides evidence that a highly restrictive state legislative climate is associated with a lower abortion rate., This cohort study evaluates the association of restrictive abortion laws in 18 states with state abortion rates., Importance Although abortion is common in the United States, patients face substantial barriers to obtaining an abortion. Recently enacted abortion restrictions pose such barriers. Objectives To assess the association between a state legislative climate that is highly restrictive toward abortion provision and the abortion rate and to evaluate whether distance to a facility providing abortion care mediates the association between legislative climate and the abortion rate. Design, Setting, and Participants This cohort study examined county-of-residence abortion rates from all states that publicly provided them and used data on abortion restrictions, facility locations, and county demographic characteristics for the years 2000 to 2014. The association between legislative climate and abortion rates was evaluated using propensity score–weighted, linear regression difference-in-difference analysis. All models included state and year fixed effects and standard errors adjusted for state-level clustering. Exposures Highly restrictive legislative climate, defined as having at least 3 of 4 types of abortion restrictions; distance to a high-volume facility providing abortion care (ie, performing ≥395 abortions per year) in miles. Main Outcomes and Measures County-level abortion rate, defined as abortions per 1000 women per year. Results Abortion rate data were obtained from 1178 counties in 18 states for a median of 12.5 years (range, 5-14). The median abortion rate was 2.89 per 1000 women (interquartile range, 1.71-4.46 per 1000 women). A highly restrictive legislative climate, when compared with a less restrictive one, was associated with 0.48 fewer abortions per 1000 women (95% CI, −0.92 to −0.04 abortions per 1000 women; P = .03). Adjusted for distance to a facility providing abortion care, a highly restrictive legislative climate was associated with 0.44 fewer abortions per 1000 women (95% CI, −0.85 to −0.03; P = .04). Each mile to a facility was associated with 0.02 fewer abortions per 1000 women (95% CI, −0.03 to −0.01 abortions per 1000 women; P = .003). Legislative climate was not significantly associated with distance to a facility providing abortion care (change in distance associated with highly restrictive climate, −2.73 [95% CI, −6.02 to 0.57] miles; P = .10). Conclusions and Relevance This study provides evidence that a state legislative climate that is highly restrictive toward abortion provision is associated with a lower abortion rate. The cumulative effect of restrictive policies may pose a barrier to abortion access.

Highlight From 11 March to 6 July 2020, a total of 268 imported cases of COVID-19 from abroad were confirmed in Guangzhou. 74% of the imported cases were detected during customs inspection and 19% under centralized quarantine. We advocate for legally enforced quarantine and monitoring of quarantined persons.

In late May, the World Health Organization (WHO) declared that the Americas have now become the epicentre of the global coronavirus disease 2019 (COVID-19) pandemic, with Latin America having passed Europe and the USA in number of daily confirmed cases. Within Latin America, Brazil is currently taking the lead with the highest number of cases and deaths in the region. Although COVID-19 is a growing ongoing issue in Brazil, Brazilian president Jair Bolsonaro does not seem very concerned with this major public health problem, having said 'So what?', when asked about the rapidly growing number of COVID-19 cases in the country..

We often talk about peace as if the concept is self-explanatory. Yet people can have various theories about what peace “is.” In this study, we examine the lay theories of peace of citizens embroiled in a prolonged ethnonational conflict. We show that lay theories of peace 1) depend on whether one belongs to the high-power or low-power party and 2) explain citizens’ fundamental approaches to conflict resolution. Specifically, we explore the link between power asymmetry, lay theories of peace, and preference for conflict resolution strategies within large-scale samples of Palestinian residents of the West Bank and the Gaza Strip and Jewish residents of Israel. Results reveal that members of the high-power group (in this case Jewish-Israelis) are more likely to associate peace with harmonious relationships (termed “positive peace”) than with the attainment of justice (termed “structural peace”), while members of the low-power group (in this case Palestinians) exhibit an opposite pattern. Yet both groups firmly and equally interpret peace as the termination of war and bloodshed (termed “negative peace”). Importantly, across societies, associating peace with negative peace more than with positive or structural peace predicts citizens’ desire for a solution that entails the partition of land (the Two-State Solution) whereas associating peace with structural or positive peace more than with negative peace predicts citizens’ desire to solve the conflict by sharing the land (the One-State Solution). This study demonstrates the theoretical and policy-relevant utility of studying how those most affected by war understand the concept of peace.

The novel 2019 Coronavirus Disease (COVID-19) pandemic has led to the closing of all but essential businesses in California. However, several nonessential businesses have remained open in Southern California despite the mandated “stay at home” order issued by the governor. As part of an ongoing vape shop project involving 88 participating shops, this study investigated the number of vape shops that remained open amidst the coronavirus outbreak and related mandates. Examination of shop social media websites and telephone calls to shops revealed that 61.4% ( n = 54) have remained open, particularly within Korean/Asian and Hispanic/Latino ethnic locations (32 of the 54 shops). Importantly, walk-in service was much higher within Hispanic/Latino locations compared to African American, Korean/Asian, or non-Hispanic White neighborhoods ( p = 0.03). It is not known if shops that stayed open were in direct violation of the order, didn’t know all the details of the order, or found a loophole in the order and believed that they were an essential business. Better communication between the vape shop industry and public health officials during this pandemic is needed.

BACKGROUND: Although all environments whom applied smoke-free zones (SFZs) have sufficient compliance rate (over 80%) in Indonesia particularly in Bogor City, it is still unclear who is doing what now on SFZs activities to assess the effectivity and efficiency of this tobacco control program. OBJECTIVES: This review aimed to present the evidence of tobacco control on SFZs programs and activities of these zones based on the several indicators set by the local government’s regulation. MATERIALS AND METHODS: A review was held to observe the SFZs local regulation archives. Data were derived from secondary sources and observation data of law enforcement teams’ generic activities and programs in Bogor City in the Province of Jawa Barat, Indonesia. RESULTS: There were eight (eight) zones designated as SFZs according to the local regulation, namely: (1) Public places, (2) workplaces, (3) places of worship, (4) children’s playgrounds and/or other gathering places, (5) public transportation, (6) teaching and learning environments, (7) health facilities, and (8) sports facilities. It resulted that 55% of these zones still uncomplied to SFZs regulation. It is still a tobacco control homework in Indonesia while it is remembering that Indonesia has the only largest country of six developing countries that have not ratified Framework Convention on Tobacco Control of the World Health Organization. CONCLUSION: The role of the SFZs’ enforcement team is crucial and consists of relevant stakeholders to optimize activities and programs of SFZs regulations with clear targeting, rewards, and punishments. However, further studies are needed to determine the effectiveness of non-smoking areas specifically.

Background On January 1, 2019, a new regulation on the control of smoking in public places was officially implemented in Hangzhou, China. On the day of the implementation, a large number of Chinese media reported the contents of the regulation on the microblog platform Weibo, causing a strong response from and heated discussion among netizens. Objective This study aimed to conduct a content and network analysis to examine topics and patterns in the social media response to the new regulation. Methods We analyzed all microblogs on Weibo that mentioned and explained the regulation in the first 8 days following the implementation. We conducted a content analysis on these microblogs and used social network visualization and descriptive statistics to identify key users and key microblogs. Results Of 7924 microblogs, 12.85% (1018/7924) were in support of the smoking control regulation, 84.12% (6666/7924) were neutral, and 1.31% (104/7924) were opposed to the smoking regulation control. For the negative posts, the public had doubts about the intentions of the policy, its implementation, and the regulations on electronic cigarettes. In addition, 1.72% (136/7924) were irrelevant to the smoking regulation control. Among the 1043 users who explicitly expressed their positive or negative attitude toward the policy, a large proportion of users showed supportive attitudes (956/1043, 91.66%). A total of 5 topics and 11 subtopics were identified. Conclusions This study used a content and network analysis to examine topics and patterns in the social media response to the new smoking regulation. We found that the number of posts with a positive attitude toward the regulation was considerably higher than that of the posts with a negative attitude toward the regulation. Our findings may assist public health policy makers to better understand the policy’s intentions, scope, and potential effects on public interest and support evidence-based public health regulations in the future.

This Article presents the first comprehensive analysis of the contribution of behavioral science to the legal response to the COVID-19 pandemic. At the descriptive level, the Article shows how behavioral insights were incorporated into the political debate regarding the legal response to the pandemic, and it highlights the potential misuse of such insights by interested parties. The Article further considers how different psychological phenomena such as loss aversion and cultural cognition influenced the way policymakers and the public perceived the pandemic, and how these phenomena and other cognitive biases affected the design of laws and regulations responding to COVID-19. At the normative level, the Article compares nudges (i.e., choice-preserving, behaviorally informed tools that encourage people to behave as desired) and mandates (i.e., obligations backed by sanctions that dictate to people how they must behave), and it argues that mandates rather than nudges should serve in most cases as the primary legal tool used to promote risk reduction during a pandemic. The Article nonetheless highlights the role nudges can play as complements to mandates.

Resumo Este artigo tem como objetivo analisar a percepção dos integrantes dos órgãos de controles interno e externo da gestão pública, acerca do papel do Conselho Estadual de Saúde na accountability das Organizações Sociais em Saúde. Trata-se de estudo analítico, com abordagem qualitativa, baseado em entrevistas semiestruturadas, com amostra intencional. Dez atores-chave responsáveis pelos mecanismos dos controles interno e externo do Sistema Único de Saúde (SUS) foram selecionados. Os dados revelaram o papel do Conselho em relação às Organizações Sociais em Saúde, que consiste em fiscalizar a gestão dessas organizações como representantes da sociedade. Agir de forma transparente, bem como viabilizar a prestação de contas das Organizações Sociais com linguagem adequada para os integrantes do Conselho, além da independência política e liberdade para fiscalização das ações de saúde, são premissas que devem ser atendidas para que o processo de acompanhamento seja mais efetivo e propositivo na visão desses atores institucionais. Abstract This article aims to analyze the perception of the members of the internal and external control organs of public management, about the role of the State Health Council in the accountability of the Social Organizations in Health. This is an analytical study with a qualitative approach, based on semi-structured interviews, with intentional sample. Ten key actors responsible for the internal and external control mechanisms of the Unified Health System [SUS] were selected. Data revealed the role of the State Health Council in relation to the Social Organizations, which is to oversee the management of these organizations as a representative of society. The need to act in a transparent manner and to enable the provision of Social Organizations in Health’s records with adequate language for the members of the Council, besides political independence and freedom to supervise health actions are premises that must be met in order for the monitoring process to be more effective and proactive in the eyes of these institutional actors.

Introduction Economic evaluations of tobacco control policies targeting adolescents are scarce. Few take into account real-world, large-scale implementation costs; few compare cost-effectiveness of different policies across different countries. We assessed the cost-effectiveness of five tobacco control policies (nonschool bans, including bans on sales to minors, bans on smoking in public places, bans on advertising at points-of-sale, school smoke-free bans, and school education programs), implemented in 2016 in Finland, Ireland, the Netherlands, Belgium, Germany, Italy, and Portugal. Methods Cost-effectiveness estimates were calculated per country and per policy, from the State perspective. Costs were collected by combining quantitative questionnaires with semi-structured interviews on how policies were implemented in each setting, in real practice. Short-term effectiveness was based on the literature, and long-term effectiveness was modeled using the DYNAMO-HIA tool. Discount rates of 3.5% were used for costs and effectiveness. Sensitivity analyses considered 1%–50% short-term effectiveness estimates, highest cost estimates, and undiscounted effectiveness. Findings Nonschool bans cost up to €253.23 per healthy life year, school smoking bans up to €91.87 per healthy life year, and school education programs up to €481.35 per healthy life year. Cost-effectiveness depended on the costs of implementation, short-term effectiveness, initial smoking rates, dimension of the target population, and weight of smoking in overall mortality and morbidity. Conclusions All five policies were highly cost-effective in all countries according to the World Health Organization thresholds for public health interventions. Cost-effectiveness was preserved even when using the highest costs and most conservative effectiveness estimates. Implications Economic evaluations using real-world data on tobacco control policies implemented at a large scale are scarce, especially considering nonschool bans targeting adolescents. We assessed the cost-effectiveness of five tobacco control policies implemented in 2016 in Finland, Ireland, the Netherlands, Belgium, Germany, Italy, and Portugal. This study shows that all five policies were highly cost-effective considering the World Health Organization threshold, even when considering the highest costs and most conservative effectiveness estimates.

Underage college student alcohol consumption results in adverse consequences for students, colleges, and communities. Unfortunately, college health practitioners have invested time and effort implementing interventions that either fail to account for the complexity of this public health problem or are not evidence-based. Consequently, in September 2015, the National Institute on Alcohol Abuse and Alcoholism published CollegeAIM, which was developed to support higher education administrators and campus health/wellness professionals in selecting appropriate interventions for reducing harmful and underage drinking. CollegeAIM is a user-friendly, matrix-based tool that evaluates and synthesizes the peer-reviewed literature associated with nearly 60 campus and community interventions. This review uses the social ecological model to highlight individual- and environmental-level strategies evaluated in CollegeAIM matrices and is intended to be a tool in determining how best to implement resources to reduce college student alcohol use and associated harms. While CollegeAIM outlines strategies to be implemented among currently enrolled college students, it is important to note drinking behaviors for some students are established prior to entering college. Thus, interventions prior to enrolling in higher education are needed. As a resource for parents and for practitioners to use and share, the “Talk. They Hear You.” mobile health (mHealth) app is also discussed and recommended.

Introduction Women have lower rates of drunken driving than men, but their share of arrests has been climbing since 1985. These trends may stem from changes in women's lives that lead to more drinking and driving, or to greater reductions in male drinking and driving. Alternatively, changes in policy and enforcement that focus on less intoxicated offenders may inadvertently target female-typical offending patterns. This paper tracked male and female drunken driving rates and the DUI sex ratio in the United States from 1985 to 2015 across three data sources. Methods The sex ratio and prevalence estimates were derived from official arrest statistics from Uniform Crime Reports, self-reports from the Centers for Disease Control and Prevention, and traffic fatality data from the National Highway and Transportation Safety Administration. Rates were assessed for four age groups (18–20, 21–34, 35–49, and 50–64), and drunken driving trends tested using Augmented Dickey-Fuller time-series methods. Results Decreases in DUI rates stagnated over the first decade of 2000, but have again begun to decline, according to self-reports and traffic fatality data, for all sex-by-age groups. Still, the gender gap in DUI arrests continues to narrow. From 1990 to the early 2000s, changes in social control that made female DUI more visible narrowed the gender gap in arrests. In more recent years, narrowing of the gap is due primarily to male rates declining more steeply than female rates. Conclusion Results indicate that we need more research to understand why female declines have not kept pace with male declines and perhaps more targeted prevention efforts aimed at women.

Numerous studies in the United States, as well as a smaller number of studies in other Westernized countries, have linked racial and ethnic attitudes to support for more punitive forms of crime control. The current study explores this relationship in Israel by assessing whether the degree to which Israeli Jews typify crime as an Israeli Arab phenomenon and/or resent Israeli Arabs is related to support for punitive criminal justice policies. The findings suggest that ethnic typification and resentment are related to general punitive attitudes, whereas ethnic apathy and resentment are related to greater support for the death penalty. Also, the relationship between ethnic typification and punitiveness is stronger among those who are less resentful.

Who decides how to establish causality?